How much rates vary
Facilitymedian $1,905 · 10th to 90th $550 to $5,370Professionalmedian $437 · 10th to 90th $302 to $2,455
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $977.24 Median $3,715.35 Typical High $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $467.74 | Professional | None | $302.00 | $416.87 | $467.74 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $812.83 | Professional | None | $380.19 | $602.56 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,905.46 Typical High $3,388.44 | Facility | None | $691.83 | $1,905.46 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $616.60 | Professional | None | $309.03 | $407.38 | $616.60 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $1,548.82 Typical High $8,912.51 | Facility | None | $436.52 | $1,548.82 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $2,454.71 Typical High $3,630.78 | Professional | None | $407.38 | $2,454.71 | $3,630.78 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $602.56 | Professional | None | $288.40 | $398.11 | $602.56 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $194.98 Typical High $218.78 | Professional | 52 · Reduced service | $151.36 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $87.10 | Professional | 53 · Discontinued | $60.26 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $295.12 Typical High $331.13 | Professional | 54 · Surgery only | $223.87 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $66.07 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $275.42 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $208.93 | $275.42 | $309.03 |
Where Arizona sits
The same service costs 5.3 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $6,378MT $1,213
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.